Traumatic brain injuries are classified as mild, moderate or severe. The Glasgow Coma Scale (GCS) is used to objectively evaluate the conscious state of all acute trauma patients. The GCS assigns a point value on a scale of 3 to 15 based on responses to verbal, motor and eye-opening stimuli. A head injury with a GCS of 13 or above generally is considered mild, 9 to 12 is considered moderate, and 8 or below is severe.
Mild Brain Injuries
Most traumatic brain injuries are classified as mild. A mild traumatic brain injury (MTBI) is a traumatically induced physiological disruption of brain function as manifested by at least one of the following:
- any period of loss of consciousness;
- any loss of memory for events immediately before or after the accident;
- any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused); or
- focal neurological deficit(s) that may or may not be transient but where the severity of the injury does not exceed the following:
- loss of consciousness of approximately 30 minutes or less;
- after 30 minutes, an initial Glasgow Coma Scale (GCS) of 13-15; and
- post-traumatic amnesia (PTA) not greater than 24 hours.
This definition was developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8(3), 86-87. Similar definitions of MTBI have been developed by the Defense and Veterans Brain Injury Center.
Moderate Brain Injuries
A moderate traumatic brain injury generally is defined as:
- Loss of consciousness of 30 minutes to less than 24 hours;
- After 30 minutes, an initial GCS of 9-12; or
- Post-traumatic amnesia of more than one but less than 7 days.
Severe Brain Injuries
A severe traumatic brain injury generally is defined as:
- Loss of consciousness of more than 24 hours;
- After 30 minutes, an initial GCS of 3-8; or
- Post-traumatic amnesia of more than 7 days.
Different Classification Systems
Different organizations use different classification systems. For example, under the Mayo Head Injury Classification System (2007), a traumatic brain injury is classified as Moderate-Severe (Definite) TBI if one or more of the following criteria apply:
- Death due to this TBI.
- Loss of consciousness of 30 minutes or more.
- Post-traumatic anterograde amnesia of 24 hours or more.
- Worst Glasgow Coma Scale full score in first 24 hours (unless invalidated upon review, e.g., attributable to intoxication, sedation, systemic shock).
- One or more of the following present:
- Intracerebral hematoma,
- Subdural hematoma,
- Epidural hematoma,
- Cerebral contusion,
- Hemorrhagic contusion,
- Penetrating TBI (dura penetrated),
- Subarachnoid hemorrhage, or
- Brain stem injury.
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Brain injury claims are complex from both a legal and medical standpoint. The challenges associated with successfully pursuing such claims certainly do not preclude recovery. However, it is essential to retain the services of an experienced brain injury lawyer to maximize your chances of success.
If you have been injured, it is important to consult with a skilled Portland personal injury attorney to discuss your injuries and legal rights. Call today for a free, confidential evaluation.